News | January 27, 2009

Nonradiologist Imaging Surges 63 Percent

January 27, 2009 - Utilization of imaging in the private office setting increased by 63 percent, according to a study that which will appear in the February 2009 issue of the Journal of the American College of Radiology (JACR).

At a time when imaging volume is being targeted as a factor in the overall rise in health care costs in the U.S., a look at Medicare data from a 10-year period has revealed that although there has been steady growth in imaging, a large portion of that growth can be attributed to studies performed by nonradiologist physicians in the private office setting.

The article Recent Shifts in Place of Service for Noninvasive Diagnostic Imaging: Have Hospitals Missed an Opportunity?, by David C. Levin, M.D., and Vijay M. Rao, M.D., et al., examines the changes in imaging volume in four groups where imaging most often takes place: in the hospital inpatient setting, in hospital outpatient facilities, in private offices or imaging centers, and in emergency departments (EDs).

The study results indicate that the utilization of imaging in the private office setting increased by 63 percent. Overall hospital market share decreased from 47 percent in 1996 to 41 percent in 2006. ED imaging saw the fastest growth at 77 percent, however, the utilization of imaging in the ED were substantially lower overall than the other three groups being studied.

In order to contain imaging growth, combat misuse of the technology, and educate referring physicians about appropriate ordering of exams, authors David P. Friedman, M.D., et al., enlisted their department in a utilization management (UM) program — an alternate to precertification — directed by a radiology benefit management program. Their study, Experience of an Academic Neuroradiology Division Participating in a Utilization Management Program, details the process by which imaging studies are approved using evidence-based guidelines from a variety of sources. The department noted a reduction in unnecessary studies: 14 percent of all studies reviewed were not performed, and about 6 percent of those ordered were reordered with a more appropriate exam.

Another article in the issue, Keeping Our Professionalism Alive in Radiology’s New Age: A Choice; Our Future, by Gregory J. Butler, M.D., discusses professionalism as forthcoming issue of importance in radiology that is to be looked at as an opportunity for development. Professionalism may be the only behavior that is likely to save radiologists from extinction, according to the author, as the radiology profession is quickly changing. As teleradiology gains footing and face time with referring physicians continually decreases, radiologist apathy is becoming an increasing threat to the profession. This article offers ways physician offices can reinforce the importance of professionalism in the workplace, as well as thoughts on the future of the specialty.

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